Biomarker · Gene alteration

EGFR exon 19 deletion

In-frame deletions in EGFR exon 19 detected by sequencing or PCR; a sensitizing EGFR mutation used as a predictive marker for EGFR tyrosine kinase inhibitors in non-small cell lung cancer.

CI-BIO-00000009EGFR graph →NCIt C126892

Also calledex19del · EGFR del19 · exon 19 del

Derived

Associated cancers (2)

Cancers mapped in ACCEPTED CIViC predictive, prognostic or diagnostic items whose variant (molecular markers) or gene (gene-level markers) is in this biomarker's scope. Counts by type and native level; each row links to the cancer's evidence tab.

Computedrule biomarker-links-v1

Cancer	Items	Predictive	Prognostic	Diagnostic	Levels A / B / C / D / E
Lung Non-Small Cell Carcinoma	21	21	—	—	10 / 7 / 1 / 3 / 0
Lung Adenocarcinoma	10	10	—	—	0 / 7 / 3 / 0 / 0

Derived

Drugs with predictive evidence (13)

Therapies named in in-scope PREDICTIVE CIViC items, plus targets of PREDICTS_RESPONSE_TO knowledge edges from in-scope variants. Sensitivity and resistance are counted separately and never merged into a verdict.

Computedrule biomarker-links-v1

Drug	CIViC items	Sensitivity	Resistance	Best level	Edges (S / R)	Cancer context
ErlotinibSmall Molecule	8	8	—	A	8 / 0	Lung Adenocarcinoma, Lung Non-Small Cell Carcinoma
GefitinibSmall Molecule	8	8	—	A	8 / 0	Lung Adenocarcinoma, Lung Non-Small Cell Carcinoma

Curated evidence

Predictive evidence items (31)

ACCEPTED CIViC predictive items in scope, grouped by molecular profile and therapy with native level, direction and cancer context. 50 per page.

civicCuratedShowing 1–31 of 31 evidence items · levels, directions and significance as curated at the source; each row links to its CIViC record.

Therapy	Cancer	Type	Level	Direction · significance	Rating (1–5)	Status	Evidence	Source
EGFR Exon 19 Deletion18
Afatinib

Regulatory

Approvals mentioning the linked drugs (225)

Approval records of the derived drug set, plus records whose indication text names this biomarker. Each record names its authority, jurisdiction, indication text and status — a drug approved in one jurisdiction for one indication is not 'approved' in general, and an approval listed here is not necessarily restricted to this biomarker.

Computedrule biomarker-links-v1

EGFR Exon 19 Deletion + EGFR L858R10
Erlotinib	Lung Adenocarcinoma	Predictive	B	Supports Sensitivity Response	4	accepted	EID3791 The phase 3 (EURTAC) study consisted of of 173 non-small cell lung cancer patients who had not had prior chemotherapy for metastatic disease (although adjuvant or neoadjuvant chemotherapy was permitte… (full text at CIViC) PMID 22285168 · Rosell et al., 2012 · Open in CIViC	civic
Amivantamab + Carboplatin + PemetrexedCombination	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	4	accepted	EID12156 In this phase III trial, 657 patients with locally advanced or metastatic NSCLC (Non-Small Cell Lung Cancer) harbouring EGFR mutations (exon 19 deletions or L858R) were treated with amivantamab plus c… (full text at CIViC) PMID 37879444 · Passaro et al., 2024 · Open in CIViC	civic
Amivantamab + LazertinibCombination	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	4	accepted	EID12131 In this trial (MARIPOSA), 1074 patients with Non-Small Cell Lung Cancer harbouring exon 19 deletion or exon 21 L858R substitution were randomized (2:2:1) to receive lazertinib-amivantamab (n=429), osi… (full text at CIViC) PMID 38942080 · Felip et al., 2024 · Open in CIViC	civic
Dacomitinib	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	5	accepted	EID11239 In this phase 3, open-label, randomized trial, 452 patients with EGFR mutation-positive non-small cell lung cancer including exon 19 deletions and exon 21 L858R point mutations were randomized into co… (full text at CIViC) PMID 28958502 · Wu et al., 2017 · Open in CIViC	civic
Erlotinib + GefitinibSubstitutes	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	B	Supports Sensitivity Response	4	accepted	EID4759 In a study of 1261 non-small cell lung cancer patients, 49.8% of the analyzed tumors had EGFR mutations including deletions in exon 19 (n=258), L858R (n=260), T790M (n=6) and insertions or duplication… (full text at CIViC) PMID 21531810 · Wu et al., 2011 · Open in CIViC	civic
Erlotinib + RamucirumabCombination	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	5	accepted	EID11240 In this phase 3, randomized, double-blind, placebo-controlled trial, 449 patients stage IV NSCLC with EGFR exon 19 deletions or exon 21 (L858R) mutations. Patients were randomly assigned in a 1:1 rati… (full text at CIViC) PMID 31591063 · Nakagawa et al., 2019 · Open in CIViC	civic
Gefitinib	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	4	accepted	EID11241 In this phase-IV, open-label, single-arm study, 106 patients with NSCLC and EGFR mutations including exon 19 deletion and exon 21 L858R point mutations were administered 250 mg daily doses of gefitini… (full text at CIViC) PMID 24263064 · Douillard et al., 2014 · Open in CIViC	civic
〃	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	C	Supports Sensitivity Response	4	accepted	EID2156 A phase 2 study of 120 stage IIIB-IV lung adenocarcinoma patients reported improved progression free survival in patients with EGFR mutation (defined as exon 19 deletion or exon 21 mutation) when trea… (full text at CIViC) PMID 24755888 · Yu et al., 2014 · Open in CIViC	civic
Osimertinib	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	5	accepted	EID11219 In this phase 3, double-blind trial, 682 patients were randomly assigned 1:1 to either osimertinib (80 mg once daily) or placebo for 3 years following complete resection of EGFR mutation positive (exo… (full text at CIViC) PMID 32955177 · Wu et al., 2020 · Open in CIViC	civic
Chemotherapy + OsimertinibCombination	Lung Non-Small Cell CarcinomaCURATED_BROADER	Predictive	A	Supports Sensitivity Response	5	accepted	EID12015 In this phase 3 clinical trial, 557 patients with NSCLC harbouring EGFR mutations (exon 19 deletion or L858R mutation) were randomly assigned to two groups and treated with either osimertinib with che… (full text at CIViC) PMID 37937763 · Planchard et al., 2023 · Open in CIViC	civic

Drug	Jurisdiction · authority	Cancer	Indication	Status	Approval date	Source
Lazertinib	CA Health Canada	—	Marketed in Canada as LAZCLUZE (DIN 02555964) under ATC L01EB09 LAZERTINIB. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Apr 28, 2025	health-canada-dpd
Osimertinib	CA Health Canada	—	Marketed in Canada as TAGRISSO (DIN 02456222) under ATC L01EB04 OSIMERTINIB. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Jul 19, 2016	health-canada-dpd
Osimertinib	CA Health Canada	—	Marketed in Canada as TAGRISSO (DIN 02456214) under ATC L01EB04 OSIMERTINIB. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Jul 19, 2016	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02528754) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Oct 8, 2024	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02528746) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Oct 8, 2024	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02517639) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Sep 15, 2022	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02517647) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Sep 15, 2022	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED FOR INJECTION, USP (DIN 02463083) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Jun 17, 2022	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED FOR INJECTION, USP (DIN 02463091) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Jun 17, 2022	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED FOR INJECTION (DIN 02515423) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	May 10, 2022	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as TARO-PEMETREXED (DIN 02480492) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	May 7, 2021	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as TARO-PEMETREXED (DIN 02429195) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Oct 18, 2018	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02438682) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	May 29, 2017	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02438674) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	May 24, 2017	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02459434) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Mar 31, 2017	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02394227) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Mar 31, 2017	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as TARO-PEMETREXED (DIN 02429209) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Feb 15, 2017	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as ALIMTA (DIN 02306433) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Post Marketsince Jan 29, 2026	Jan 9, 2009	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as ALIMTA (DIN 02253437) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Post Marketsince Sep 17, 2021	Aug 3, 2004	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02534096) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED (DIN 02455498) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02454610) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Aug 1, 2019	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02442833) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Sep 30, 2024	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02454629) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Aug 1, 2019	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02454637) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Aug 1, 2019	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED (DIN 02455528) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02441616) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Feb 28, 2022	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02411016) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Sep 30, 2024	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02472619) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION USP (DIN 02482967) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as ACT PEMETREXED (DIN 02428784) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Jul 24, 2018	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as ACT PEMETREXED (DIN 02428776) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Jul 24, 2018	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as ACT PEMETREXED (DIN 02428768) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Jul 24, 2018	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02411024) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	withdrawnsource: Cancelled Pre Marketsince Sep 30, 2024	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02517655) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02554534) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02528762) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02534088) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Pemetrexed	CA Health Canada	—	Marketed in Canada as PEMETREXED DISODIUM FOR INJECTION (DIN 02554542) under ATC L01BA04 PEMETREXED. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approved	—	health-canada-dpd
Ramucirumab	CA Health Canada	—	Marketed in Canada as CYRAMZA (DIN 02443805) under ATC L01FG02 RAMUCIRUMAB. Indications are not published in the Drug Product Database — see the Health Canada Product Monograph.	approvedsource: Marketed	Sep 10, 2015	health-canada-dpd

Associated cancers (2)

Drugs with predictive evidence (13)

Predictive evidence items (31)

Approvals mentioning the linked drugs (225)

Active trials (334)

Linked publications (28)